How to Understand CPT Coding

CPT coding is a way for doctors and other health professionals to document what procedures and services were done. This is important because it allows for a uniform way of filing medical procedures for insurance purposes. Doctors are reimbursed for their services based on the CPT code, and insurance providers use this information to determine what the patient owes as well as what the insurance company will pay.

Instructions

• 1

  Obtain the necessary paperwork. CPT codes can be found on discharge paperwork, on bills from health care providers, and from "explanation of benefits" paperwork from insurance companies and Medicare.

• 2

  Locate the CPT code. This code will usually be next to all entries for any service performed. CPT codes will either be entries of 5 digits or 4 digits and a letter.

• 3

  Search the American Medical Association's website. In the resources section I have provided a link to their CPT lookup service.

• 4

  Contact your doctor's office. Your local physician (or the professional who has provided the services for which you have been billed) will be able to help you match the CPT codes to specific services. This can be especially helpful if you would like an explanation of what each procedure entails.

• 5

  Call your insurance company. Your local customer representative will also be able to explain to you what each CPT code means and what services were provided.